Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Montana for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Montana only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Montana (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Lewis And Clark Emergency Physicians P C (NPI 1083668651)

Field	Value
Entity Type	Organization
Organization	Lewis And Clark Emergency Physicians P C
Address	2475 E Broadway St
City	Helena
State	MT
ZIP	59601
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 19, 2006

Payer Source	Total Paid
Medicaid	$6.6M
Medicare	$0

Key Findings

This provider is effectively single‑payer in the dataset: there is no Medicare billing on file and all lifetime recorded revenue is Medicaid at $6.6M, which limits cross‑payer comparisons and indicates the practice’s financial footprint in the public payer space is concentrated in Medicaid. The NPI was enumerated on 2006-05-19 (~20 years ago), indicating an established presence in the market despite the single‑payer billing pattern.

Revenue is highly concentrated in three emergency department E/M codes: the precomputed top three Medicaid codes account for 100.0% of the provider’s total Medicaid revenue, signaling a tight dependency on ED evaluation-and-management services for overall income. That concentration suggests limited diversification across other service lines or procedure codes in the Medicaid data.

The code mix is dominated by high‑ and moderate‑acuity ED visits, consistent with an emergency medicine physician taxonomy: 99285, 99284, and 99283 together drive the entire Medicaid revenue base, which implies the group operates primarily as an emergency department staffing organization handling a spectrum of acuity levels. The average paid amounts ($149 for 99285, $111 for 99284, $63 for 99283) further reflect higher unit payment for higher‑acuity encounters.

99285 is the single largest revenue driver: 25.4K claims, $149 avg paid/claim, $3.8M revenue (57.5% of this provider's total Medicaid revenue). The provider ranks #4 of 55 in‑state and sits in the 94th percentile, a disposition described as notably above typical state volume; this positions the group as a major statewide supplier of high‑acuity ED services.

99284 represents the second revenue tier with 19.2K claims, $111 avg paid/claim, $2.1M revenue (32.5% of this provider's total Medicaid revenue). The provider ranks #13 of 75 and is in the 84th percentile, a characterization labeled as typical/unremarkable volume, indicating solid but not outlier participation in moderate‑acuity ED care.

99283 contributes the remainder of the top three with 10.4K claims, $63 avg paid/claim, $652.1K revenue (9.9% of this provider's total Medicaid revenue). Ranking #20 of 88 and at the 78th percentile (typical/unremarkable), this lower‑paid, higher‑volume code suggests the practice also manages a material caseload of lower‑acuity ED visits but is not an outlier for that service.

Critical care billing is negligible in the Medicaid dataset: 99291 appears only 13 claims for $1.6K revenue (reported as 0.0% of total Medicaid revenue) and ranks #19 of 21 in‑state. This very low utilization of 99291 indicates the group’s Medicaid activity is overwhelmingly centered on E/M emergency visits rather than documented critical care time.

Taken together, the data paint a picture of an established emergency medicine practice (NPI ~20 years) that is heavily Medicaid‑dependent and concentrated in ED evaluation-and-management services, with a particularly strong statewide position for high‑acuity visits (99285). The absence of Medicare billing on file means competitive assessments should focus on the Medicaid market and the provider’s significant role in serving high‑acuity ED demand within Montana.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	25,350	$150	$3.8M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	19,250	$110	$2.1M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	10,350	$60	$652K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	10	$120	$1.6K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Montana providers billing the same CPT/HCPCS codes.

Claims Volume vs. Montana Distribution

Lewis And Clark Emergency Physicians P C — 0 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	4	60	2,160	$80	$526.7K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	13	80	2,770	$60	$471K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	20	90	2,330	$40	$281.3K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	19	20	100	$160	$100.9K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Lewis And Clark Emergency Physicians P C, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John Horning	CA	Emergency Medicine Physician	$68K	$25.7K
Andrew Michel	MT	Emergency Medical Services (Emergency Medicine) Physician	$83.8K	$0
Adam Plate	MT	Emergency Medicine Physician	$71.8K	$0
Andy Coil	MT	Emergency Medicine Physician	$68.3K	$0
Trent Jensen	MT	Emergency Medicine Physician	$62.6K	$0
Patrick Mclaughlin	MT	Physician Assistant	$40K	$0
Erik Kinzer	WA	Family Nurse Practitioner	$35.7K	$0
Aaron Peters	MT	Physician Assistant	$30.3K	$0
Brenna Scofield	MT	Family Nurse Practitioner	$8.7K	$0

Nearby Providers

Other providers in the same ZIP code as Lewis And Clark Emergency Physicians P C, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Mont	MT	Adult Care Home Facility	$0	$34.7M
Intermountain Deaconess Home	MT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$11.9M
County Of Lewis & Clark Lewis & Clark County School District #1	MT	Local Education Agency (LEA)	$0	$10.8M
Pediatric Dentistry PC	MT	Pediatric Dentistry	$0	$9.9M
Montana Children's Home & Hospital	MT	General Acute Care Hospital	$0	$8.7M
Region Iv Family Outreach, Inc	MT	Case Manager/Care Coordinator	$0	$7.3M
Montana Independent Living Project	MT	In Home Supportive Care Agency	$0	$6M
St. Peter's Health	MT	Family Medicine Physician	$0	$5.2M
Edgewood Helena Senior Living LLC	MT	Assisted Living Facility	$0	$4.7M
Montana Surgery Center	MT	Ambulatory Surgical Clinic/Center	$0	$4.6M

Lewis And Clark Emergency Physicians P C — Billing Profile & Reimbursement Data

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Lewis And Clark Emergency Physicians P C — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References